Another part of the puzzle of the growing link between HIV and cardiovascular disease is unveiled!

Cardiovascular disease and APC (epicardial adipose tissue) in seropositive patients

The heart is a large muscle that helps to move blood around the body. Despite its important pumping action, the heart is not simply a muscle; about 20% of this organ consists of a fatty layer called TAE (epicardial adipose tissue). This layer acts as a source of energy for the heart as it is high in saturated fat. Many adipose tissues can release hormones, called adipokines, that affect the health of arteries and other parts of the cardiovascular system, and researchers believe that SAD can produce such hormones.

Affecting heart health

In studies with HIV-negative patients, the researchers found evidence of inflammation in SAD in patients with coronary artery disease. In addition, in these people, APT contained cells of the immune system, such as macrophages and T cells. APR in obese people produces chemical signals that produce inflammation in other cells.

Researchers do not know precisely how APR plays a role in heart disease, but they suspect that excess APR can affect cardiac muscle function and an increase in inflammation in the blood vessels of the heart.

APR and other parts of the human body

The researchers made the following findings about SAD.

The volume of APT is related to the fat that deposits in the abdomen (visceral fat) and is often deposited around vital organs of the abdomen, such as the liver ...

The excess of SAD has also been associated with abnormal blood sugar levels and a decrease in peripheral insulin sensitivity, both precursors of diabetes and thickening of the arteries.

The disturbances of the electrical activity of the heart have also been associated with the excess of SAD.

Given the interest in APR and cardiovascular disease in HIV-negative patients, the researchers turned to the study of SAD in seropositive patients.

With repeated high-resolution computed tomography scans of the chest, a research team in Modena, Italy, measured changes in APR over a period of 18 months in more than 200 seropositive volunteers who were on ART Antiretroviral).

During the study, the researchers also measured the level of calcium that was deposited in the arteries. Calcium, which comes from dead cells and cell debris that accumulate along the vessels because of inflammation, form sticky deposits called "plaques."

The Italian researchers found that, in general, men tended to have higher increases in SAD compared to women. The increase in APR volume was associated with increased calcium deposits in the arteries. Researchers believe that part of the reason for the excess of SAD and calcium deposits in some participants may be due to abnormal stimulation of the immune system by chronic HIV infection.

Study Details

The researchers recruited 240 participants between January of 2005 and June of 2011. All were adults and on antiretroviral therapy during the previous 18 months. None of them had a heart attack, stroke or peripheral vascular disease and, on the other hand, none of them had undergone elective or urgent cardiovascular surgery.

Upon entering the study, the "average profile" of the participants was as follows:

  • 68% Of men, 32% of women
  • Age - 47 years
  • Count of CD4 + T cells <500 cells
  • Viral load less than 40 copies / ml (undetectable)
  • 50% Did not perform physical exercises
  • 40% Had higher than normal blood pressure
  • BMI (body mass index) and a relative body fat assessment were considered as "within a range considered *** healthy ***".
  • Two CT scans were performed with an average of 18 months between them.

From this information we obtained the levels of APR and calcium deposits in the arteries.


Men generally had significantly higher amounts of APR (88 mm3) than women (61 mm3). In addition, increased TAB volume were literally linked to males.

During the study, the proportion of participants whose APR volume increased was 64%. The APR volume remained stable or decreased among the other participants.

The increase of calcium deposits in the coronary arteries occurred among 10% of the participants, most of whom were men. Participants who had larger calcium deposits in the coronary artery were more likely to have an increase in their SAD volume during the study.

The immune system and cardiovascular diseases

Infections with viruses and other microorganisms activate the immune system and release chemical signals that incite inflammation. This is a normal response and usually helps to alert the cells of the immune system about an infection. It also helps to alter the metabolism and affects the behavior of many organs and apparatus in a way that is useful in fighting infections, click here to know more. However, after the infection has been brought under control, the immune system is generally able to return to its normal state, as well as levels of immune and inflammatory activation. Because the immune system (and its cells) is distributed throughout the body, a constantly activated immune system affects the functioning of many other organs and systems, including the heart and blood vessels.

HIV infection causes the immune system to remain activated. This activation is greatly reduced when people who are HIV-positive in ART, but because ART does not cure HIV infection, the immune system continues to be activated. Like this, studies have shown that people with HIV are at increased risk for cardiovascular disease. It is not yet known exactly how HIV increases the risk for cardiovascular disease, but many teams are investigating possible reasons for this elevated risk.

In analyzing their medical records and extracting and analyzing data, the Italian researchers found an association between the increase in CD4 + cells detected after participants started receiving ART (antiretroviral therapy) to an increase in APR volume. This does not mean that the increment of CD4 + cells caused the growth of Epicardial Adipose Tissue. Instead, researchers suspect that some of the CD4 + cells have been activated and that these activated cells have caused inflammation in the APR. Unfortunately, the research team did not conduct detailed immunological sub-studies necessary to assess whether CD4 + cells were actually activated.

Italy's findings are yet another piece of the puzzle of the growing link between HIV and cardiovascular disease. In addition, they emphasize the importance of investigating calcium deposits in the arteries and variations in the volume of Epicardial Adipose Tissue.

Studies in HIV-negative patients and obese people have shown that significant changes in diet can reduce levels of SAD.

Studies in seropositive patients are needed to find out whether decreasing the volume of SAD can be done with diet, exercise and other attempts to reduce inflammation in the short term. Long-term follow-up is needed to assess whether these interventions result in improved health among HIV-positive people.

Claudio Souza
This is responsible for the translation and adaptation to Portuguese of Brazil

Note from the Editor of Seropositive Web Site: Leaving aside the problems, the issue of continuous infection of the organism (I remember me from a doctor who explained to me that my propensity to generate "Thrombus" and the consequent constant risk of pulmonary embolism (I had two in ten years) is due in part to a genetic condition, which he believes exist based on medical history and missing my mother (I do not see there at least 15 years ). The fact is that if you ever eaten chicken heart skewers, you have seen, even the TAE, Adipose Tissue epicardial, and you know what they are talking about (this "back fat" which is on top of the chicken little heart) ; however, adhere to the Wisdom and Goodness of God, the Supreme Intelligence, the Cause of Causes and it's just that I register my excitement brought about by the Mercy of Our Eternal Father ... Not far I want to catechize and evangelize, I do not profess any religion and dispense stone temples as _adoração of places to Deus_; My work is my prayer and, in the measure of Divine Justice, I can dare to say that now, after nearly fifteen years of dedication to this site, I am, as I said, with lower rate before my Heavenly Father. The more I read, translate and publish, the more I charm me with God and his inscrutable designs .... Nothing more to say!


CATIE's fact sheet on HIV and cardiovascular disease

-Sean R. Hosein


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Nasir K, Rubin J, Blaha MJ, et al. Interplay of coronary artery calcification and traditional risk factors for the prediction of all-cause mortality in asymptomatic Individuals. Circulation: Cardiovascular Imaging. 2012; in press.
Zone S, P Raggi, Bagni P, et al. Parallel Increase of subclinical atherosclerosis and adipose tissue epidcardial in patients with HIV. American Heart Journal. 2012, 163: 1024-1030.
Libby P, Ridker PM, Hansson GK. Progress and challenges in translating the biology of atherosclerosis. Nature. 2011, 473: 317-325.
Triant VA. HIV infection and coronary heart disease: an intersection of epidemics. Journal of Infectious Diseases. 2012, 205 (supplement 3): S3550-S361.
J Lo and Plutzky J. The biology of atherosclerosis: paradigms general and distinct pathogenic mechanisms Among HIV-infected patients. Journal of Infectious Diseases. 2012, 205 (supplement 3): S368-S374.
Hsue PY, Deeks SG and PW Hunt. Immunological basis of cardiovascular disease in HIV-infected adults. Journal of Infectious Diseases. 2012, 205 (supplement 3): S375-S382.

This information was provided by CATIE (Canada Exchange of AIDS treatment information). For more information, contact CATIE, 1.800.263.1638 or Catie. The credit must appear on any online publication, with a link back to the original.

The translation into Portuguese of Brazil can be used without prior authorization and, however, is the person or institution that makes use of this version a requirement for all claims, including all underlined text.

English translation for the Portuguese of Brazil (it does not exist Brazil with "z" and "BraZil" is an idiomatic aberration created for persons that only God knows why they do this ...) of the original in Cardiovascular disease and EAT in HIV-positive people by Claudio Souza.

If you have good knowledge of the English language and have time to assess my translation and send your comments to this address E-mail

Yes, this is the photo of me! My niece asked me to put this picture on my profile! .... I had here a description of me that one person described as "irreverent". This is really a euphemistic way of classifying what was here. All I know is that an "NGO" which occupies a building of 10 floors has established a partnership with me, and I have the logs of the partnership time, which was more a vampirism because for each 150 people leaving my site, clicking on them, there was, on average, one that came in. WHEN I ENTERED AND ENTERED

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